Clinical significance of organic hypomenorrhea

Hypomenorrhea may be divided into functional (hormonal insufficiency or overstimulation) and organic types. This study concerns 23 consecutive cases of organic hypomenorrhea. Their chief complaints were sterility, habitual abortion, and hypomenorrhea. The diagnosis of the hypomenorrhea is based on the history, study of ovarian function, hysterography, laparoscopy, and diagnostic curettage. Three forms of organic hypomenorrhea are described: (1) Endometrial tuberculosis was found in 8 cases in which the diagnosis was based on tubercular changes in the endometrium or tubes and characteristic hysterographic changes including lymphatic intravasation. In all these cases the hypomenorrhea was primary. (2) Intrauterine adhesions were found in 6 cases. In all of these the hypomenorrhea was secondary to curettage in the puerperium or after abortion. Following the lysis of intrauterine adhesions, the menstrual pattern returned to normal. (3) Endometrial insufficiency (sclerosis) was found in 10 cases in which the secondary hypomenorrhea, which followed curettage in the puerperium or following abortion, was characterized by absence of intrauterine adhesions, normal ovarian function, absence of response to hormone therapy, scanty endometrial tissue on curettage, and a clinical picture of sterility or recurrent abortions.